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Please complete all required entries below. If needed for reference the full Multi-society Interventional Pulmonology Fellowship Accreditation Standard can be accessed at http://aippd.org/resources/accred-doc/.

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You are being asked to allow your responses to the AABIP/AIPPD Interventional Pulmonology Fellowship Accreditation application to be used to study the demographics, curriculum, and structure of interventional pulmonology (IP) fellowship training in the United States. As an applicant for IP fellowship accreditation how you structure the foundations of your fellowship will help us better understand the current state of IP training in this country and help develop tools and pursue resources to optimize training across all programs and ensure quality.

If you agree to participate your answers to the accreditation survey will be deidentified and included in an analysis of current education practices within IP. The specific data pertaining to your program, which will include such metrics as number of faculty, duration of training, graduate board certification completion, etc will not be shared in any way that can be directly attributed to you or your program. Data collection will be completed once the survey closes on June 30, 2018. Participation in this study is completely voluntary and neither you nor your institution will receive any form of remuneration or favorable treatment as payment for your participation.

There are no risks to you or your institution from taking part in this study.

The benefits which may reasonably be expected to result from this research study are a better understanding of current resources devoted to IP fellowship training to include faculty time, online standardized curriculum, fellow pay and benefits, etc. This information may be used to pursue additional resources for IP fellowship training nationwide.

Please understand your participation is voluntary and you have the right to withdraw your consent or discontinue participation at any time without penalty. Specifically, your fellowship program accreditation status will not be jeopardized in anyway if you choose not to participate.

If you have any questions about this research study you can contact John Mullon, MD at 507-284-3104. If you have any concerns, complaints, or general questions about research or your rights as a participant, please contact the Mayo Institutional Review Board (IRB) to speak to someone independent of the research team at 507-266-4000 or toll free at 866-273-4681.

Please indicate below your willingness to participate in this study. By selecting "Yes" you give permission to use your responses to the accreditation application for research purposes. By selecting "No" you decline permission to use your responses to the accreditation application for research purposes.

Please enter the email address you would like the Joint IP Fellowship Accreditation application forwarded to.

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